26 Nov

Got Shoulder pain? 

            Shoulder problems are common, especially in the older population. Rotator cuff problems are believed to be present in as many as 25% of those over the age of 50 – though these are not always symptomatic. Guess what I just turned 35, and I’ve had a torn labrum, a rotator cuff injury, arthritis, tendonitis and more. You are probably saying I am a major athlete…try again!

            It all started in January 2018. I was on call one night. It was late around 10:45PM and I was all alone to do an EEG on a patient in the NCCU (Neuro-Critical Care Unit). I was pulling the EEG machine off the elevator and all off a sudden I felt a tug on my arm and an excruciating pain in my shoulder. I was in the hallway at this point and turned around and the machine was still in the elevator stuck on a lip that was a few inches lower than the landing. I had to use both arms and lift the EEG machine up and over the couple inch difference. I felt another rip of pain go through my shoulder. Mind you, this is late at night; there is no one to help me. I continued down the hall and went to my patient. The whole time I was doing the EEG, my shoulder was on fire. I figured I pulled a muscle or something.

            That night I had a hard time getting into a comfortable position, I got maybe 2 hours of sleep; when I got up at 5am to get to my regular shift I was in pain and very sleepy. Someone in the lab asked me why I was in a bad mood and I reminded them I had been on call the night before and I hurt my shoulder. My manger said to be careful and keep an eye on it. Well a day and another painful night went by and my shoulder still had no relief. You have to remember at this point I was on heavy doses of Gabapentin which is used to calm down nerve pain, but I still had a ripping sensation and an awful burning that I could pinpoint its exact location.

            The second day of pain, I mentioned to by manager I needed to see occupational health and make a report; I was in pain and it was affecting my job. EEG is very labor intensive. A little background for you is: I start by pushing or pulling a very large machine across the huge hospital to the patient’s room. Most times the patient is not lying flat so I need to pull the patient up so their head is at the top of the bed, move the large hospital bed out so I can squeeze behind it. I then have to crawl over and under any lines of meds being pumped in or fluids being drained out from the patient. Once I am behind the patient I have to measure, prep and place all 26 electrodes on the head and various places on the body, this part can take anywhere to 15 minutes to 45 minutes depending on the patient’s cooperation. Then while mostly standing you need to record the EEG while continually typing notes for 20-30 minutes. Clean up and on to the next patient over and over and over. On a normal day 6-8 patient are seen. Some time techs take an unneccesary amount of time working on one patient and will not see as many patients as myself, but I am organized and very good at my job, so I do an accurate test in good timing without rushing.

            Now you know what I do on a daily basis and on call at night. So, I go to occupational health, they do not examine me, just sign a paper and tell me to finish my shift and then go to an urgent care nearby. I inform them I am in too much pain and they have me ask my manager for permission to eave early. Seriously??? So I go to an urgent care they had provided me the address of. The place is disgusting and let me remind you this is the end of January. I waited 2 hours to see a doctor and I keep hearing the diagnoses of every patient in the surrounding rooms: All were testing positive for the flu. Great, just I what I needed! Finally I get an XRAY, the Doctor comes in to see me and go over the results. He was a mix between Charlie Chaplin and Hitler and his voice was like a high pitched Elmer Fudd. He says he thinks I pulled a muscle because the XRAY showed no broken bones. He gives me a note out of work for that day, and light duty restrictions for a few weeks and to see Physical Therapy with a prescription for Motrin.

            I go back to work the next day; with light duty restrictions, there is plenty to be done in the lab. I don’t do any heavy lifting, per the lead techs; I work on computer programs and catch up work that everyone hates doing in the lab. This goes on for about a week, the manager gets word from her manager that our EEG lab does not allow people to work there with restrictions; you either work full duty or you’re out. So, I am sent home and told I am out of work until I can be cleared for full duty. Occupational health calls me and starts a workman’s comp case to cover my pay for the next few weeks I will be out. While I am out for my first day of workman’s comp I get a call from Occupational health. They tell me they found a position for me to do in the hospital with my restrictions and I am to report to the infection control department on Monday. I normally start my shift at 7am, but someone should be there to let me in.

            Monday comes and I am on time like always (I hate being late) and there is no one to let me in. Building is locked up like Fort Knox. I have security let me in and I wait. Finally, someone shows up at 8:30 to show me what I am supposed to be doing. I feel like there is a lack of communication at this point and it’s only the first day. I start my shift on the floors doing hand hygiene and making notes on every person I witness washing or not washing their hands. Buy the first hour my shoulder is killing me, by the third hour I call occupational health to report this. The nurse suggests I wait it out and try to work my whole shift. By 5 hours, I tell her I can’t do this job. I can’t finish an 8 hour shift, let alone do it day after day. Again I am sent to the same nasty urgent care for another 4 hour wait to be told the same thing. This time though Occupational Health gets me an urgent appointment to see an Orthopedic Doctor for the following day.

            I see the orthopedic doctor and he says because of my pain and symptoms he thinks I have a torn labrum and schedules me for an MRI. MRI confirms I have a labrum tear and some tendonitis. I am referred to a shoulder surgeon. Back up to before the MRI, I am out of work collecting a measly paycheck and unable to do anything because of my pain, but by protocol I am told an MRI takes up to 30 days to get approved. So, now it is April and I finally get in to the see the surgeon. I need another stupid XRAY for what reason I don’t know, the first one showed no broken bones. He looks at my MRI and me and says it’s a 50/50 chance if I need surgery. He says to get a cortisone shot and see if that helps and we’ll go from there. No extra appointment is made; he has me sign a paper and sticks me with a needle. Oh My God! That hurt! He tells me I will get some relief in about a day or so, for the next 24 hours I probably will feel what’s known as a cortisone flare up.

            Cortisone flare up came the next morning. I woke up and it felt like someone had ripped my shoulder off and then tried to fit it back on my body after twisting it left and right and up and down. It was the worst pain ever. I had my kids 12 years ago; I don’t remember contractions hurting as bad as this. I literally felt like I could pass out, my blood pressure was through the roof. I told my husband if surgery is even close to this feeling I wont have it, so I hope this cortisone shot helps. Well, 2nd morning comes and I wake up and the flare pain is gone, hallelujah, but that ripping feeling from my labrum tear is still there and it hurts. I call the doctors office and I tell the secretary “The doctor said if the cortisone shot doesn’t work I can have surgery, so I am calling to schedule the surgery.” She replies with “Oh, I’m sorry but this is going through workman’s comp, surgery isn’t covered until 3 months after a cortisone shot.” First of all, no one told me that, some choice words came out of my mouth. Needless to say I had an appointment with the doctor for the following day.

            The following day the doctor clears up any miscommunication and says everything is all set, they had a cancellation and I get my surgery done in a few days. Wow! Threaten to kill secretaries and surgery is scheduled with a snap of the fingers. All the paperwork gets done, arrangements are made for the kids and I get my sling and ice machine ahead of time. I am nervous because I have no idea what to expect with a shoulder surgery, but I am ready for this pain to go away, this has been months of pain that Motrin is not touching. I literally started taking CBD oil a few weeks before surgery and I hadn’t really felt the effects yet.

            Surgery day comes, everything is on schedule. I kiss my husband goodbye and off I go. A few hours later the doctor comes out and tells my husband he found a lot more issues than what the MRI showed and instead of 2-4 incisions I had 6 incisions. He repaired my labrum, shaved a bone and cut a bone that never fused properly from my infant days…maybe my mother really did drop me on my head as a baby JHe gestimates 6-8 month recovery, but feeling better by 4-6 months. While I am in the recovery room I am sick as a dog. I have never had an issue with anesthesia, I have had surgeries before but I am dry heaving all the emptiness of not being able to eat the night before and literally just felt like shit. But my arm was finally numb; I had gotten a nerve block and was told I would not feel my arm until the next day.

            Well, painful days went by and then I started physical therapy. I was able to move my arm a little but needed to be in a splint for 6 weeks. I did therapy 2-3 times a week every week. I was progressing with range of motion but I still had a lot of pain. I told my doctor and he says that’s normal. Work calls and says I should come back with light duty, I ask what kind of light duty and they say the same one I could not do before surgery. I remind them that even though the injury was worked on, I underwent a lot of work and I don’t think I can do the job. Regardless I go in, and as before the job was too painful, I call occupational health and they say I need to see a doctor again. I am pretty pissed off. Why do I need to see a doctor again? We know what the issue is, I am still healing from an extensive shoulder surgery. I go back to my surgeon; I say I still have a lot of pain, I can’t do light duty something, needs to be looked at, maybe you didn’t fix the problems, maybe something new is going on, and he orders another MRI and gives me another cortisone shot that does not help. So, because I have to leave work a second time workman’s comp gets all up in arms and wants me to get a second opinion. I am scheduled for a second opinion, an IME (independent medical exam) pretty much calling me out, so they can get a different doctor to say I am fine and able to return to work.

            I go to my second opinion. I meet the surgeon and tell him where my pain is and what I can do with my arm (which isn’t much because of the pain). He goes through all the surgery notes and previous MRI and asks me if I had a bicep tendonesis? I say No, I never had a problem with my bicep. He goes on to tell me that if he was my surgeon he would have done a bicep tendonesis, the reason behind this is that I had an extensive surgery performed and my bicep tendon should have been tacked down for further support. He said without tacking down the tendon, my bicep muscle is trying to do more activity now that I am healing and being told to exert more force is pulling my shoulder in all different ways. So in layman’s terms it is causing an unstable shoulder to move in wrong directions and could cause more damage. He suggests I need exploratory surgery and a bicep tendonesis. He also agrees that I need a new MRI. I am sure the insurance company is kicking themselves now because he also said I am not able to return to work.

            More time has now gone by, I have been waiting for an approval for another MRI, it is October, 6 months after my surgery and months of me complaining of the same pain I had BEFORE surgery. The day comes for my MRI Arthrogram, I was told that having that study will give more detailed information. I go in, the radiologist injects dye by an ultrasound guided needle and he points to the screen and says “See that? That’s your rotator cuff shredding away.” Seriously WTF? The rest of the MRI sucks, they put me in positions that hurt on a regular basis and tell me to hold it like that for several minutes while being squeezed into a tube. Not how I wanted to spend my morning. Now I have been told by another surgeon my surgeon fucked up and didn’t do what he was supposed to do, and now I have a radiologist telling me I have more damage to my shoulder than was originally done by me getting stuck on the elevator. I have a follow up appointment to see my surgeon.

            I go to the appointment, I have my new MRI Arthrogram and the second opinion the insurance company made me get. I give everything to him and he says, “I agree, you need another surgery, it looks like you have a recurrent labrum tear.” Then he asked me “Did you have a fall or an accident after surgery.” I say “Um no, I haven’t. It looks like it never healed; I haven’t been able to do any kind of forceful things because I have been in pain as I told you all this months after surgery.” And he starts drawing on a piece paper how my labrum tear looks and what he did last time and what he’s going to do this time and how he’s going to fix my rotator cuff that is now shredding and how now he is going to do the bicep tendonesis he never did and he had no excuse why the labrum wasn’t fixed the first time. He says he will try to get me in next week for surgery. I left the office so mad. The balls of this man! He only fixed a portion of my labrum, he did more extensive bone issues that had never bothered me my entire life, and then did not do a procedure that all doctors would have done with my unstable shoulder.

            I am now waiting to see a new surgeon to take on my case and get this second surgery. At the end of January I got hurt because the hospital I work at has unsafe conditions. I had an MRI, I developed a labrum tear, I had a failed cortisone shot, I had a failed surgery, months of PT, another failed cortisone shot, more months of PT, a MRI Arthrogram and now I need a labrum repair/rotator cuff/bicep tendonesis surgery. Needless to say, a lawyer has been called. It’s now November, I don’t know when the surgery will be approved and there will be extra risk going in a second time and I get to this shoulder recovery thing all over again. By the time I am healed, I will not have a job to go back to. Heads up to anyone who needs shoulder surgery… Get a 5 star surgeon and listen to your body, you know when something is wrong. I also advise to get a workman’s comp lawyer as soon as an injury occurs. They have been my biggest advocate. If it wasn’t for them, I would have signed a paper returning to work and ending the workman’s comp case. These hospitals know the lingo and how to screw you over. At the end of the day it’s about money not treating their staff adequately. I need to not worry about someone's feelings and take care of myself. 

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